Effect of Qingxuan Jiangya decoction on renin-angiotensin-aldosterone system of primary hypertension patients / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the clinical therapeutic effect of Qingxuan Jiangya decoction on patients with primary hypertension (PH) and its influence on their rennin-angiotensin-aldosterone system (RAAS). Methods A prospective study was conducted, including 178 patients with definite diagnosis of PH (Ⅰ-Ⅱ grade) who came from Guanggu district to the third Hospital of Wuhan City from April 2016 to March 2017, and they were divided into a control group and an observation group according to the method of taking medicine, each group 89 cases. The control group received 5 mg amlodipine besylate, orally once a day; the observation group on the basis of treatment in the control group, the Qingxuan Jiangya decoction (gastrodia rhizome 20 g, uncaria 20 g, ligusticum rhizome 15 g, salviae miltiorrhizae 10 g, puerarin 20 g, radix ophiopogonis 20 g, fructus lycii 25 g, chrysanthemum 10 g, root poria 15 g, poria cocos 10 g, radix glycyrrhizae 5 g) was added, a dose (400 mL) divided into two parts, one part taken twice daily, in the morning and in the evening after meals; the two groups took the treatment continuously for 4 weeks. The blood pressure dynamic changes and plasma levels of renin, angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) and clinical efficacy were observed, and the safety of the drugs was evaluated by measuring the changes of liver and kidney functions. Results After treatment in the two groups, the daytime systolic pressure (D-SBP) and diastolic pressure (D-DBP) and nighttime SBP (N-SBP) and DBP (N-DBP), the mean of 24 hours-SBP and 24 hours-DBP were all lower than those before treatment, and the D-DBP, N-SBP and 24 hours-DBP of the observation group were significantly lower than those of control group [D-DBP (mmHg, 1 mmHg = 0.133 kPa) 78.24±5.35 vs. 81.56±6.23, N-SBP (mmHg)117.35±5.42 vs. 122.63±7.23, 24 hours-DBP (mmHg) 74.15±5.26 vs. 80.51±6.52, all P < 0.05]; after treatment, the levels of renin, Ang Ⅱ and ALD in two groups were also declined, and the degrees of decrease in the observation group were more significant than those in the control group [renin (ng/L) 5.46±0.41 vs. 7.82±0.36, ALD (ng/L)128.48±31.42 vs. 168.48±28.32, Ang Ⅱ (ng/L) 52.35±14.27 vs. 75.38±15.65, all P < 0.05]; there were no significant changes in the levels of alanine aminotransferase (ALT), aspartate transaminase (AST), urea and creatinine (Cr) before and after treatment in the two groups, showing that the treatment was safe. Conclusion Qingxuan Jiangya decoction can effectively and safely reduce the blood pressure in PH patients, and its mechanism is possibly related to its influence on RAAS.